Sunday, August 24, 2014

The start of another school year means, for me, another opportunity to make sure that nonverbal and minimally verbal students have robust aac systems they can use to communicate, are getting intervention to teach them how to use their systems effectively in all situations, and are getting real literacy instruction. A tall order, I know.

So, I decided it’s time to review those myths about aac that keep many students from getting the communication systems they need.

Myth #1 is that this child is too “low functioning” to learn to use aac

In fact, there are no cognitive prerequisites for using aac

Nobody is too “low functioning” to communicate. Even infants communicate, and learn to do so differentially.

Myth #2 is that only someone who is nonverbal should use aac.

In fact, many people with some speech can and do use aac effectively to communicate - that is why they call is AUGMENTATIVE as well as ALTERNATIVE communication.

Many children whose verbal skills are not sufficient to meet all of their communication needs, and many children whose verbal skills are developing very slowly - much more slowly than their understanding of language -

and many of those whose speech is not intelligible enough to all listeners

should be using aac.

Myth #3

If no or low tech systems haven’t worked, then higher tech systems won’t work either.

In fact, many low tech systems fail specifically because they do not offer sufficient vocabulary to meet the person’s needs. I have often seen children whose low tech systems have been unused or abandoned. Frequently this is given as the reason why something more “complex” hasn’t been tried. To the contrary, however, why the less robust stems have failed is exactly because they have not offered enough communication strength for the user.

Myth #4

There is a sequence - from no tech to low tech to high tech - through which an aac user must progress

In fact, the constant progression from one system to another - with the accompanying constantly moving position of words - actually makes learning more difficult for the aac user.

Myth #5

The child must show ability to discriminate the picture, and show that he knows what it means, before we put it into his aac system

In fact, there have been studies done that show that teaching the child to identify the picture symbols does nothing toward making him able to use them.

On the other hand, putting them into the aac system, providing adequate aided language stimulation and using them consistently goes far towards teaching the child how to use them.

Myth #6: Get the behavior under control first.

In fact much of what we see as inappropriate behavior has a communicative function. Providing a communication response that serves that function will actually decrease the behavior. You cannot eliminate a behavior without providing an alternative; by providing an effective communication response the behavior can be reduced.

Myth #7

This will be a crutch.

For some users, aac may be a short term solution, to be used while they are acquiring more verbal skills. For some, aac is a useful strategy for repairing a communication breakdown - rather than as a primary mode of communication.

What is true is that for people who see themselves as verbal - whenever or however those verbal skills develop - their verbal skills will always be their primary mode of communication.

it is almost always true that people would prefer to be verbal, if that is possible.

Myth #8: If he uses aac he won’t develop speech.

In fact, it has been shown through research and anecdote that aac users who have speech potential almost always develop more speech through use of aac.

Myth #9: Carrying that around makes him look too different.

However, not being able to participate in activities, or interact with peers, or engage with anyone will also make him look different - and will keep him from being able to access the curriculum.

Myth #10: Giving someone an aac system will solve his communication problems.

An aac system is only a tool. As with any tool, how well we use it and produce with it is dependent upon how well we have been taught to use it. Children who are not taught effectively often do not learn to use the system effectively. That does not mean that they do not have the potential to do so; only that we have failed to teach them.

To recap:

Nobody is too “low” anything to use aac

There is no progression from no to low to high technology

Children do not need to demonstrate ability to recognize the symbol before it is put into their aac system

Monday, August 18, 2014

Back to school transition time can be stressful for typical kids. It can be especially stressful for kids with special needs. Transitions, however, happen everywhere in our lives. We change settings, activities, communication partners. Often any transition can be difficult for our students. Changes in routines, in people, places, activities can result in major melt-downs for some kids. (Yes, I have years of not-so-fond memories of getting my own son back to school.)

One way to prepare kids for these changes is to give them lots of visuals to help them process what you are telling them. Even when we think they are understanding everything we are saying, most kids with language disorders miss at least a part of it, and most don’t remember it beyond 10 days, 10 minutes, or even 10 seconds.

Visual cues are more permanent. They can be referred back to. They can reduce the time it takes to transition by preparing kids in advance. They can reduce our nagging by reminding them what they need to do visually. They provide clear steps that reduce the load of trying to process multiple directions or steps.

In addition to providing these visual cues, we may need to decide how far in advance we need to provide the cue. For some transitions, 1 or 2 minutes may be enough. For other, bigger changes, we may need to start to prepare days in advance. We may need to provide a visual cue that shows not just the transition, but also the period of time. Calendars can be used for longer periods - such as when the first day of the new school year is. Students can mark off each day as it ends. Visual timers help with shorter periods; like how much time before the bus gets here. For students who need to physically mark off the time, there are ways to “count down” the time by removing numbers or images from a visual cue card or page.

Using photos as visual cues is a great way to show exactly where the child is going and who or what (s)he will see when (s)he gets there. Take a picture of the school, the classroom, and - if possible - the teacher. (Tell the principal how important it is that you have this picture!) Having this transition visual card with him while on the bus or in the car can help the child remember where he is going. (Hint:Make multiple copies, so you don’t have to worry about it getting lost before the next day.) For some children, having another transition visual with them during the day to remind them that “FIRST___” (they complete their school day activities), “THEN____” (they go home to Mom) can help them get through those first few new days.

Create visual schedules to show the “new” school day schedule - as opposed to those lazy summer days (which have, no doubt, been anything but lazy for you). Just as teachers will create visual schedules of the school day to get them through their new routines there, have a schedule of what they need to do to get ready for school., such as FIRST getting dressed, eating breakfast, brushing teeth, THEN getting on the bus or into the car. Make another to remind them of what they do when they get home. This one can serve to remind them to FIRST put away their lunch box and backpack, go to the bathroom, and THEN get a snack.

Don’t forget to grab these free FIRST-THEN graphics

to print and use.

Using visual cues for schedules, sequences, and transitions can help your child adjust to their new school days. How else do you use visual cues to get ready?

Sunday, August 10, 2014

Every September (or insert your start date here) students around the country have, for years, written the dreaded What I Did Over Summer Vacation essay. But how do our students who are not writers, who are nonverbal, who have significant communication disorders participate in this age-old school tradition?

For many students in substantially separate classrooms (whatever your state calls them), they’re not given the opportunity - or the challenge. They have not been given robust literacy instruction, are non-readers or emergent readers, and maybe are emergent writers - if they write at all.

However, technology has given us a wonderful array of tools with which to answer this question and solve this problem. There are iPads in every classroom I go into, and most of “my” kids have their own for communication or other academics. I work with these teachers and parents to help their student create personal narratives. The kids with whom I work LOVE these. Creating books about them, with familiar pictures of them involved in activities, having experiences they can remember meets their goals in many areas: language, vocabulary, reading, writing, conversing. I have kids who can spend hours listening to their personal stories over and over again. These are kids who otherwise don’t ever sit still. There is a magical power in these stories that are about them. We can harness that power to build language and engagement and communication.

There are a lot of story building apps on the market. Pictello, iBookCreator, Shutterfly, Story Creator, Story Maker HD - just to name a few. The basic process is the same. Take or import photos on the iPad, import them into the app, in whatever sequence is appropriate, add text and record. Then, watch the magic. *

* And do a little teaching - having the tools is meaningless if we don’t teach students how to use them.

“Having a piano does not make a musician anymore than having an aac device makes you a proficient communicator” David Beukelman 1991

If you need a little bit more direction: Make sure you have photos that are clear, that represent the activity or event, and that the student can see. Ask parents for vacation pictures that show an event; including the people who were there, where they were, what they did, and - hopefully - a sequence of what was done.

Work with the student to choose pictures, identify those elements that answer the Who, What did, When, Where questions; as well as, the “How was it?” question. Encourage some commenting. Did the student have a good time? Does (s)he want to do it again? Was it funny, scary, sad, silly? Involve them in the writing process as much as possible. Then put it all into the app.

Don’t forget to print out a hard copy, too. Always have a paper back-up of any system or digital book.

Looking for a fun book to share with your class? Try “How I spent My Summer Vacation” by Mark Teague. I have a resource full of fun language lessons and activities in my TPT store here

And grab the free handout on using apps to develop personal narratives. If you missed it in an earlier post, it is here.

Sunday, August 3, 2014

Believe it or not, back to school time is here. Some districts I know are already back. Amazing in the heat of summer. Others don’t start until after Labor Day. Whenever you start, you are surely ramping up to get ready for the coming school year.

As my years of being a speech-language pathologist have passed (more than 35 of them) I have seen changes in my profession and changes in the focus areas we are serving. There are fewer and fewer articulation cases making it onto caseloads in many districts, as children with more pressing language and communication needs fill the rolls. And we are taking a more active role in the areas of reading and writing, which are - let’s face it - basically language tasks related to communication.

So, what do the Common Core State Standards mean for SLPs? How broad does our scope become and what do we have to offer to the classroom that relates to the CCSS?

The CCSS present a unique challenge to the Special Education classrooms where w, of course, want students held to the highest possible standards and to be provided with the curriculum to meet them. However, the disabilities of these students make reaching those goals at their own grade level difficult to achieve.

What must be held in mind is that these standards are a continuum. As you look at them, the same threads run from Kinder through the rest of the grades, with only the level of complexity and specific details changing for many of them in ELA.

As SLPs we are uniquely qualified to address vocabulary instruction, formulation of oral and written language, and comprehension of text. We have proven methods for increasing vocabulary comprehension and use. We have the tools and experiences to grow expressive language formulation. We are the teachers of descriptive language. We understand the underlying language involved in phonological awareness skills.

Speech-language pathologists know that reading is a language-based task, and that reading difficulties stem from difficulty with the language components of sound/phoneme manipulation and vocabulary deficits. The CCSS identify “Foundation Skills” that include phonological awareness and phoneme awareness. SLPs have stepped up in recent years in their involvement in teaching and remediating these skills.

There are a few basic types of text structures in written (and oral) language. Speech pathologists have spent much time and effort on narrative skills. There are tests of narrative skills, dynamic assessment and intervention programs, rubrics and developmental charts for narrative skills development. There is less information and research on development of other speaking and writing styles in the speech pathology literature. These have, historically, been the bailiwick of teachers and resource room specialists. We do, however, provide intervention for students who have difficulty with formulating, organizing and producing text of any sort. We were, in many places, the first proponents of graphic organizers. Our understanding of how students formulate language, retrieve words, and monitor or self-correct their expression is what teachers often rely upon.

Speech Pathologists are uniquely trained to understand building Listening and Speaking skills of Oral Language, as well as Reading and Writing of Written Language. Reading involves both decoding and comprehension, the latter of which we are more routinely involved with. Written language deals with spelling, handwriting, and written composition, the latter of which we are, again, mostly concerned with. Oral language is particularly important for young students, whose learning and academic progress are strongly influenced by early experiences with vocabulary they hear. Even later, research shows that reading comprehension continues to be influenced by these early experiences with vocabulary. Once decoding is tackled, comprehension is most influenced by vocabulary. Vocabulary builds upon itself.

As speech-language pathologists we have always addressed the building, retrieving, using and expanding of vocabulary. Intervention has moved from the pull-out to more push-in models, but it has not necessarily changed our focus on specific skills in vocabulary acquisition and use. Many of us focus on what are considered Tier 2 words; those that go beyond the basic and add color and specificity to what our students say. Some of us also work with students who have difficulty with acquiring even the Tier 1 words. We have the expertise, as well, in giving teachers strategies for building Tier 3 vocabulary within the classroom, based on the strategies we know and use.

Many speech-language pathologists are unsure of what their role is in adopting the CCSS and teaching students those skills outlined. But reading the standards reassures us that there is not really anything new.

Syntax skills - for speaking, for reading comprehension, and for writing

and...all things language.

So, don’t panic or stress out. Keep on doing what you have been doing to make your students successful language learners and language users. Keep your eye on the continuum of skills as you work with your students who, by definition of meeting criterion for receiving intervention, are not at age or grade expectations.

What is important to note about the CCSS is the emphasis on not just access to the general curriculum but also adherence to these standards for students in special education. Students receiving special education services are being held, more than in the past, to these same standards. Which mean that we, as therapists and teachers, need to strive to prepare our students for meaningful participation in classrooms and for their lives after school.

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